topography 引导的经上皮光性角膜切削术矫正放射状角膜切开术后不规则屈光不正。

Topography-guided transepithelial photorefractive keratectomy to correct irregular refractive errors after radial keratotomy.

机构信息

From the Department of Ophthalmology (Ghoreishi, Peyman, Koosha, Golabchi, Pourazizi), Isfahan University of Medical Sciences and the Department of Research and Development (Ghoreishi), Parsian Clinic of Ophthalmology, Isfahan, Iran.

出版信息

J Cataract Refract Surg. 2018 Mar;44(3):274-279. doi: 10.1016/j.jcrs.2017.12.015. Epub 2018 Mar 30.

DOI:10.1016/j.jcrs.2017.12.015

PMID:29610024

Abstract

PURPOSE

To evaluate the efficacy and safety of topography-guided transepithelial photorefractive keratectomy (PRK) in a group of patients with post-radial keratotomy (RK) showing irregular corneas.

SETTING

Feiz University Hospital, Isfahan, Iran.

DESIGN

Prospective case series.

METHODS

Consecutive patients who had irregular astigmatism after RK with stable refraction and topography for at least 1 year were recruited. All eyes had excimer laser topography-guided single-step transepithelial PRK. The efficacy, safety, predictability, and corneal wavefront aberration changes were assessed 6 months after the surgery. Vector analysis was performed using the Alpins method to evaluate the astigmatic treatment.

RESULTS

Twenty-two patients (22 eyes) were enrolled. The patients' ages ranged from 37 to 61 years (45.77 years ± 4.9 [SD]); there were 12 men (54.54%) and 10 women (45.46%). Uncorrected distance visual acuity significantly improved after 6 months of treatment (0.45 ± 0.19 logarithm of the minimum angle of resolution [logMAR] preoperatively and 0.25 ± 0.19 logMAR after 6 months) (P < .001). Moreover, the corrected distance visual acuity significantly improved at the end of the study (0.14 ± 0.13 logMAR preoperatively and 0.09 ± 0.11 logMAR after 6 months) (P = .01). Furthermore, the aberrometric values were significantly reduced at the 6-month visit (P < .001). The mean of the surgically induced astigmatism was 2.15 ± 1.44 diopters. No significant complication was observed.

CONCLUSION

Topography-guided single-step transepithelial PRK is a safe and effective method for treating the irregular refractive errors in post-RK patients.

摘要

目的

评估在一组因放射状角膜切开术（RK）后出现不规则角膜的患者中，基于地形的经上皮准分子激光光折射性角膜切削术（PRK）的疗效和安全性。

地点

伊朗伊斯法罕费兹大学医院。

设计

前瞻性病例系列研究。

方法

连续招募了 RK 术后至少 1 年且屈光稳定和地形图稳定的伴有不规则散光的患者。所有患者均接受基于地形图引导的单步经上皮 PRK。术后 6 个月评估疗效、安全性、可预测性和角膜波前像差变化。使用 Alpins 方法进行向量分析，以评估散光的治疗效果。

结果

共纳入 22 名患者（22 只眼）。患者年龄 37 至 61 岁（45.77 岁±4.9 岁）；男 12 例（54.54%），女 10 例（45.46%）。术后 6 个月时，未矫正远视力显著提高（术前 0.45±0.19 对数最小角分辨率 [logMAR]，术后 0.25±0.19 logMAR）（P<0.001）。此外，研究结束时矫正远视力显著提高（术前 0.14±0.13 logMAR，术后 0.09±0.11 logMAR）（P=0.01）。此外，6 个月时的像差值显著降低（P<0.001）。手术诱导的散光平均值为 2.15±1.44 屈光度。未观察到明显的并发症。